Treatment to lower high cholesterol can be carried out with different types of medication, which must be prescribed by the doctor. Generally, the first line drugs are statins, and bile acid scavengers or nicotinic acid are considered in some cases, such as those in which the person cannot tolerate statins, for example.
There are situations in which the doctor can also advise the combination of two drugs at the same time, in order to optimize the results, namely in cases where LDL levels are very high or when there is a high cardiovascular risk.
Some of the most commonly used cholesterol-lowering drugs are:
| Medicines | Examples of medicines | Mechanism of action | Possible side effects |
|---|---|---|---|
| Statins | Pravastatin, simvastatin, fluvastatin, atorvastatin, rosuvastatin. | They inhibit the production of cholesterol in the liver. | Gastrointestinal changes and headaches. |
| Bile acid sequestrants | Cholestyramine, colestipol, colesevelam. | They decrease the intestinal reabsorption of bile acids (produced in the liver from cholesterol), leading to the stimulation of the conversion of cholesterol into more bile acids to compensate for this decrease. | Constipation, excess intestinal gas, fullness and nausea. |
| Ezetimibe | Ezetimibe. | They inhibit the absorption of cholesterol in the intestine. | Respiratory infections, headache, back pain and muscle pain. |
| Fibrates | Fenofibrate, genfibrozil, bezafibrate, ciprofibrate and clofibrate. | They alter the transcription of genes involved in the metabolism of lipoproteins. | Gastrointestinal changes, increased liver enzymes and the risk of gallstone formation. |
| Nicotinic acid | Nicotinic acid. | It inhibits the synthesis of triglycerides in the liver, leading to an increase in the breakdown of apolipoproteins, reducing the secretion of VLDL and LDL. | Redness of the skin. |
As a complement to drugs to lower high cholesterol, a healthy lifestyle should be adopted, such as healthy eating, regular physical exercise, weight loss and reduced cigarette use and alcohol intake, that contribute to the increase in HDL cholesterol and decrease in LDL cholesterol.
Natural cholesterol-lowering remedies
Natural remedies can also be indicated to control blood cholesterol levels, but they must also be used under medical guidance and respecting the guidelines of each package leaflet or label.
Some foods, plants or natural supplements that can be used to lower cholesterol include:
- Soluble fibers, such as oats, pectin present in various fruits or flax seeds, because they contribute to the reduction of cholesterol absorption and the absorption of bile salts at the intestinal level; Green tea, which contributes to the reduction of LDL cholesterol due to reduced absorption of cholesterol and reduced production of cholesterol in the liver; Red rice yeast, monacoline K, which has a similar mechanism of action to statins and therefore inhibits cholesterol production in the liver; Phytosterols, which are present in foods, such as fruits, vegetables and vegetable oils or in supplements such as Collestra or Gerovital, for example. Phytosterols also inhibit cholesterol production in the liver; Soy lectin, which contributes to increased metabolism and transport of fats, helping to reduce cholesterol. Soy lectin is also available in dietary supplements, as is the case with the brand Stem or Sundown, for example; Omega 3, 6 and 9, which contribute to the reduction of LDL cholesterol and increased HDL cholesterol. Omegas are present in several brands of food supplements or foods such as fish, olive oil, avocado, nuts and flaxseeds, for example; Chitosan, which is a natural fiber of animal origin, which contributes to the reduction of cholesterol absorption at the intestinal level.
In addition to cholesterol-lowering drugs or supplements, it is also important to eat a balanced diet low in fatty foods and fried foods.
Watch the following video and learn more about what to eat to maintain healthy cholesterol levels:
